title: Cardioprotective role of insulin: Advantage analogues.
abstract: OBJECTIVE
  Type II diabetes mellitus (DM) increases the risk of cardiovascular disease. Treatment with insulin substantially reduces C - reactive protein (CRP) because of its anti-atherosclerotic action. This study was designed to explore and compare the cardio protective role of regular human insulin (RHI), aspart and lispro insulin in type II DM.
  
  
  METHODS
  A randomized, open, parallel group, comparative clinical study was conducted on 90 patients of type II DM. After baseline clinical assessment and investigations, RHI was prescribed to 30 patients, aspart insulin to 30 patients and lispro insulin to another 30 patients for 12 weeks. The efficacy variables were change in blood pressure, glycemic control, lipid profile, serum potassium, high-sensitivity CRP (hsCRP) and UKPDS 10-year CHD risk scoring over 12 weeks. At the end of the study, the patients were followed up and changes in variables from baseline were analyzed by statistical tools.
  
  
  RESULTS
  Systolic blood pressure decreased significantly in aspart group (P = 0.008) whereas diastolic blood pressure was decreased significantly both in aspart (P < 0.001) and lispro group (P = 0.01). Fasting, postprandial blood glucose and HbA1c were decreased in all three groups significantly but change in aspart group was superior (P = 0.01). Triglyceride was significantly better controlled by lispro (P < 0.01) whereas aspart insulin was superior to decrease total cholesterol and LDL (P < 0.05). The extent of potassium loss was significantly more with RHI (P = 0.004) than others. CRP-lowering effect (P = 0.017) and decrease in UKPDS risk scoring (P = 0.019) in aspart and lispro group was superior to RHI group.
  
  
  CONCLUSIONS
  Short acting insulin analogues, especially aspart insulin have been found to have a better cardio protective role than RHI in type II DM.
authors.affiliation: Department of Pharmacology, Prathima Institute of Medical Sciences, Nagunur Road, Karimnagar, Andhra Pradesh, India.
authors.forename: Rituparna
authors.initials: R
authors.lastname: Maiti
authors.forename: Jyothirmai
authors.initials: J
authors.lastname: Jaida
authors.forename: Pulukuri John Israel
authors.initials: PJ
authors.lastname: Leander
authors.forename: Mohammed
authors.initials: M
authors.lastname: Irfanuddin
authors.forename: Idris
authors.initials: I
authors.lastname: Ahmed
authors.forename: Anuradha
authors.initials: A
authors.lastname: Palani
keywords: Type II diabetes mellitus; UKPDS 10-year CHD risk; hsCRP; insulin analogues; regular human insulin